NPI | 1962986877 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 5649) |
Additional Taxonomies | 183500000X Pharmacist (Licence: SC 37849) |
363A00000X Physician Assistant (Licence: SC 5649) | |
Enumeration Date | 2018-09-18 |
Last Update Date | 2025-01-22 |